Nonalcoholic fatty liver disease in a district general hospital: clinical presentation and risk factors
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Nonalcoholic fatty liver disease (NAFLD) affects one-fifth of the adult population and is currently the commonest liver problem in the western world. The prevalence of NAFLD is likely to rise over the coming decades in parallel to the obesity and diabetes epidemics. A retrospective study was undertaken in a UK. district general hospital (DGH) to determine the clinical and laboratory features of patients with NAFLD.
Methods and findings
A total of 48 patients with NAFLD were identified. Most (54%) were asymptomatic on presentation and 90% had an echogenic liver on ultrasonography (USS). Liver tests were elevated in the majority, but did not distinguish between simple steatosis and steatohepatitis. Having features of the metabolic syndrome and a low platelet count (P = 0.028) may help identify patients with advanced hepatic fibrosis.
NAFLD is common in the DGH and should be considered in all patients with metabolic risk factors. A liver biopsy should be considered in those with low platelets, type II diabetes mellitus, and the metabolic syndrome.
KeywordsDistrict general hospital Liver tests Metabolic syndrome Nonalcoholic fatty liver Ultrasonography
White cell count
International normalized ratio
Body mass index
Adult treatment panel
- 12.George J, Farrell GC. Management of NASH: current and future perspectives on treatment. In: Farrell G, George J, de la Hall PM, McCullough AJ, editors. Fatty liver disease: NASH and related disorders. Malden: Blackwell Publishing; 2005. p. 194–207.Google Scholar
- 13.Office for National Statistics. Obesity among adults: by sex and NS-SeC. Social Trends 2001;34.Google Scholar
- 21.Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). J Am Med Assoc. 2001;285:2486–97.CrossRefGoogle Scholar
- 23.George J, Farrell GC. Practical approach to the diagnosis and management of people with fatty liver diseases. In: Farrell G, George J, de la Hall PM, McCullough AJ, editors. Fatty liver disease: NASH and related disorders. Oxford: Blackwell Publishing; 2005. p. 181–93.Google Scholar
- 29.Donthamsetty S, Bhave VS, Mitra MS, et al. Non alcoholic steatohepatitis (NASH) sensitizes liver to hepatotoxicity. Hepatology. 2005;42:631A.Google Scholar
- 31.Kessler A, Levy Y, Roth A, et al. Increased prevalence of NAFLD in patients with acute myocardial infarction independent of BMI. Hepatology. 2005;42:623A.Google Scholar
- 43.Targher G, Bertolini L, Padovani R, et al. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30(5):1212–8. [Epub 2007 Feb 2].Google Scholar